PMID- 16484964
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20060306
LR  - 20060217
IS  - 1121-421X (Print)
IS  - 1121-421X (Linking)
VI  - 49
IP  - 4
DP  - 2003 Dec
TI  - Gastro-oesophageal reflux disease and Helicobacter pylori.
PG  - 235-41
AB  - The interaction between gastro-oesophageal reflux disease (GERD) and Helicobacter 
      pylori (H. pylori) infection has been the subject of intense scrutiny in recent 
      years. Although the evidence base is incomplete it is now sufficient to clarify a 
      number of key questions. H. pylori is not a risk factor for reflux disease. 
      Similarly, H. pylori infection, in most patients, is not ''protective'' against 
      the risk of developing reflux and oesophagitis. Furthermore, reflux and 
      oesophagitis are not more likely to develop or to worsen after H. pylori 
      eradication therapy and eradication does not make control of reflux symptoms with 
      proton pump inhibitor (PPI) therapy more difficult. Long term PPI therapy in the 
      presence of H. pylori infection does increase the rate at which gastric mucosal 
      atrophy and intestinal metaplasia develop. Eradication therapy has been shown to 
      reduce this risk. In the uninfected stomach, PPIs are associated with a low 
      likelihood of these adverse histological changes. PPI therapy reduces the 
      accuracy of diagnostic tests for H. pylori. The decision to test for and treat H. 
      pylori infection in the context of reflux must be individualised based on patient 
      factors including co-morbidity, age, gastric histology, family history and 
      informed choice. Distinction must be made between treating symptoms and 
      potentially reducing risks. A decision not to test for and treat H. pylori is now 
      just as active a choice as is the decision to test and treat. Recent 
      international consensus statements recommend eradication of H. pylori prior to 
      long term PPI therapy in reflux disease, although there is not a universal 
      agreement on this. Further research to clarify the risk and benefits of such an 
      approach is required.
FAU - Katelaris, P H
AU  - Katelaris PH
AD  - Gastroenterology Department, University of Sydney, Concord Hospital, Concord, 
      Sydney, Australia. pkatelar@mail.usyd.edu.au
LA  - eng
PT  - Journal Article
PL  - Italy
TA  - Minerva Gastroenterol Dietol
JT  - Minerva gastroenterologica e dietologica
JID - 9109791
EDAT- 2006/02/18 09:00
MHDA- 2006/02/18 09:01
CRDT- 2006/02/18 09:00
PHST- 2006/02/18 09:00 [pubmed]
PHST- 2006/02/18 09:01 [medline]
PHST- 2006/02/18 09:00 [entrez]
PST - ppublish
SO  - Minerva Gastroenterol Dietol. 2003 Dec;49(4):235-41.